The role of advanced midwives regarding maternity care in tertiary hospitals in Gauteng

Abstract:

The researcher explored the role of advanced midwives allocated in maternity
care in tertiary hospitals in Gauteng. Advanced midwives form part of the
multidisciplinary team in Gauteng tertiary hospitals in accordance with the
staffing norms as prescribed by the Maternity Guidelines of South Africa for
advanced practice nurses. Advanced practice nursing (APN) strengthens
nursing and advanced practices to assist and fill in where there is a shortage of
physicians in rural and densely populated areas. The scope of practice in
tertiary hospitals for advanced practice nurses is not explicit; the role of
advanced midwives in these hospitals is not clearly defined and, as a result, the
role of the advanced midwife and physician overlap in tertiary hospitals in
South Africa.
A qualitative, exploratory, descriptive and contextual research design was
followed. Advanced midwives allocated in three selected tertiary hospitals in
Gauteng served as the study population. After conducting a pilot study at the
fourth tertiary hospital in Gauteng, data collection occurred during three focus
group interviews. Field notes were taken. Application letters for obtaining
ethical permission and permission in the setting were sent to the chief
executive officers (CEOs) of the three selected hospitals. All ethical principles
were strictly adhered to. A moderator was used to conduct the focus groups in
a quiet setting of each hospital. Participation was voluntary and informed
consent was signed. The collected data was analysed by using the 8 steps of
the Tesch’s model of data analysis. Trustworthiness was adhered to with
confirmability, credibility, dependability and transferability. The study findings
were discussed and confirmed by literature control. The limitation of this study
was highlighted.
The findings revealed three main themes: positive attributes of advanced
midwives, responsibilities of advanced midwives in tertiary hospitals and
challenges posed by patients who do not adhere to the admission criteria. The recommendations were made for the support and supervision of the
utilisation of advanced midwives in tertiary hospitals by the Gauteng
Department of Health employing body, support by training institutions/universities, support for advanced midwives by nursing
management, and self-empowerment of the advanced midwife.
The conclusion was that advanced midwives are not optimally utilised. Support
recommendations were made to different stakeholders on strengthening
multidisciplinary team decision making on management of patient care. Further
research studies on the placement of advanced midwives within tertiary
hospitals were recommended.